Plantar Fasciitis

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Plantar fasciitis is an inflammation of the sheet of fibrous tissue that connects your heel to your toes and provides support to the arch. Wear and tear in the ligaments of this thick band of connective tissue leads to its irritation. As a result, inflammation develops and causes stabbing heel pain and stiffness.

Causes of Plantar Fasciitis?

Stress and too much tension lead to repeated small tears fibrous fascia. If these tears are beyond the repair capability of the body, inflammation develops and causes pain and other symptoms. The cause may also be the degeneration of fibrous fascia. Certain factors increase the risk of developing plantar fasciitis, such as:

• Old age (between 40 and 70)
• Being female
• Pregnancy
• Obesity
• flat or high arched feet
• Tight Achilles tendon
• Occupations and activities that put a lot of pressure on the plantar fascia. For example, working in the factory, teaching, running long distances.

Diagnosis of Plantar Fasciitis?

Signs and Symptoms

• There will be stabbing pain but may also be dull
• Pain is worse in the morning, after rest or sitting for a while
• Usually pain fades away with activity but gets worse after it
• Pain that flares up after prolonged standing due to increased irritation and inflammation
• Normally pain that increases over many months, but it may reduce spontaneously

You may also feel stiffness and swelling at the bottom of your feet.

• Imaging tests like X-rays and MRIs are not necessary. If performed, they help rule out other conditions such as bone fractures, arthritis.
• Ultrasonography is the best to confirm the diagnosis. There will be thickened plantar fascia.

MINIMALLY INVASIVE TREATMENT FOR Plantar Fascitis

• Platelet-rich plasma injection

Surgery, the last resort, is performed only when the pain is severe; and other options have failed.

PRP THERAPY

Platelet-rich plasma is a form of regenerative medicine. It uses injections of your own blood platelets to help with healing.

What Is Platelet-Rich Plasma?

Platelets, or thrombocytes, are a type of blood cell. Their main function is clotting blood. They’re produced in your bone marrow. Platelets contain growth factors. These are proteins that may be helpful in healing injuries.

How Does Platelet-Rich Plasma Work?

A healthcare professional will collect a small amount of your blood (approx. 15-20 ml only). They will place your blood into a centrifuge. This spins your blood at different speeds until it separates into different layers. One layer is the platelet-rich plasma. This layer of plasma may have as much as three-four times more platelets than regular blood.‌

The platelet-rich plasma will then be injected into your affected area. We will first numb the area with local anaesthetic. The pain at the site may increase for the first 1-2 days. It could take 1 week before you feel any improvement.‌

After your treatment, we will recommend you to:

• Avoid taking non-steroidal anti-inflammatory medications ( NSAIDs) after your treatment as this may block the effect
• Avoid activities that put stress on the area of treatment for a few day

Is Platelet-Rich Plasma Treatment Effective?

The effectiveness of platelet-rich plasma treatment depends on several factors, including:

• Your overall health
• Whether your injury is chronic (it developed over time) or acute (sudden and serious)
• Which part of your body needs treatment
• The preparation of the platelet-rich plasma treatment

Many clinical trials have supported its use.

Some studies have found that platelet-rich plasma injections significantly reduced pain compared to placebos. People’s physical function also improved significantly. These benefits continued at 3, 6 and 12 month follow-ups.

There’s no chance of an allergy or immune reaction to platelet-rich plasma treatment because the plasma is taken from your own blood. Side effects and complications are rare.

What does the procedure involve?

The doctor will clean the area over the joint and insert a small needle into the fluid filled area around the joint bones under imaging guidance. When it is in the correct position, they will inject the PRP into the joint. They will remove the needle and cover the injection site with a small dressing.

Why Not (Contraindication)?

Occasionally it is difficult to inject much medicine into the joint space, especially if the joint is extremely swollen. If this is the case, other medicines may be prescribed to reduce the swelling before the injections are tried again.

What you are to do before procedure (Preparation)?

1. Book prior appointment if elective or get admission in causality if emergency
2. Lab investigation (*PT/INR, CBC), XRAY, CT/MRI scan and previous records.
3. 2-3 Hours fasting.
4. If you are on blood thinner like Aspirin, inform during appointment.
5. One accompanying person
6. Need to sign a consent form for procedure

Approx. Stay in hospital?

We have very fast and competent working team (Consultant, fellow, clinical assistant, technician and ward assistant) which provide you comfortable atmosphere and ease your nerves. Usual time of stay is around few hours.

Complications

Every procedure carries a risk, although this is extremely small. The risk of infection with this procedure is extremely small as no incisions are made in the skin.

Resume to work?

You can resume your work after 1 day if existing disease allows.